In Rheumatoid Arthritis, Resistance to Changing Medications Has Decreased Over Time

Fewer patients with rheumatoid arthritis (RA) are unwilling to change their RA therapies in 2021 compared with patients with RA in 2006, according to research results presented at ACR Convergence 2021, the annual meeting of the American College of Rheumatology.¹

Investigators used data from participants enrolled in the longitudinal registry FORWARD, The National Databank for Rheumatic Diseases. Patients answered questions on treatment satisfaction and preferences—including an overall assessment on their likelihood of changing their rheumatoid arthritis medications—in 2006 and/or 2021.

In 2006, a total of 6282 respondents (mean age, 63 years; RA duration, 17 years) with an exposure to 3 disease-modifying antirheumatic drugs (DMARDs) participated. In April 2021, participants included a total of 1623 respondents (mean age, 66 years; RA duration, 24 years) with an exposure to 4 DMARDs. A total of 442 respondents completed questionnaires in both 2006 and 2021.

In 2006, 64% did not want to change their medication, so long as their condition did not get worse, compared with 51% in 2021. Among those who completed questionnaires in both years, there were no significant differences in the willingness to change therapies.

The primary reason for an unwillingness to change therapies included medication satisfaction (53% in 2006 vs 37% in 2021), risk of side effects (72% vs 43%), and health care provider recommendation (71% vs 38%). In the multi-year questionnaire group, respondents who provided a reason for not changing their medications in 2021 were “moore likely to have provided the same reason in [2006],” according to researchers.

Investigators identified satisfactory RA control, risk of side effects, fearing loss of control, health care provider feelings on current medications, and lower pain levels as predictors of an unwillingness to change medications. Costs and insurance were associated with an unwillingness to change medications in 2006, but not 2021.

“Further data are needed to understand whether the correlation between (un)willingness to change treatments and disease activity and clinical outcomes has evolved over time,” the researchers concluded.

Reference

1. Michaud K, Pedro S, Jasion V, et al. Resistance of patients with rheumatoid arthritis to changing therapy: A 15-year follow-up. Presented at: ACR Convergence 2021; November 3-9, 2021. Abstract 1158.